Outcomes Following Endovascular versus Open Repair of Abdominal Aortic Aneurysm

2017 ◽  
Author(s):  
SreyRam Kuy ◽  
Kai J. Yang ◽  
Anahita Dua
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Vascular Surgery ◽  
Clinical Case ◽  
Open Repair ◽  
Short Term ◽  
Abdominal Aortic ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in vascular surgery assessing whether endovascular repair of abdominal aortic aneurysm (AAA) improves short-term outcomes compared to traditional open repair. The OVER trial demonstrated comparable results at 2-year follow-up between the two groups. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

Long-Term Outcomes of Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysm

2017 ◽  
Author(s):  
SreyRam Kuy ◽  
Kai J. Yang ◽  
Anahita Dua
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Surgical Intervention ◽  
Long Term Outcomes ◽  
Abdominal Aortic ◽  
Study Intervention ◽  
Early Surgical Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in vascular surgery examining whether early, prophylactic repair of small abdominal aortic aneurysm (AAA; 4.0 to 5.5 cm) improves 5-year survival. The study found that among patients with a small AAA <5.5 cm in diameter, early surgical intervention confers no survival benefit over initial surveillance. The chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) Trial

2018 ◽  
Author(s):  
Nikhil Gupta ◽  
Catherine Chiles
Keyword(s):  
Coronary Artery Disease ◽  
Clinical Case ◽  
Short Term ◽  
Interpersonal Therapy ◽  
Randomized Evaluation ◽  
Artery Disease ◽  
Study Intervention ◽  
Overall Health Status ◽  
Landmark Study

This chapter provides a summary of a landmark study in psychiatry in primary care to mediate the effect of depression on overall health status . In the treatment of patients with major depression and coronary artery disease, what is the short-term efficacy of a selective serotonin reuptake inhibitor (citalopram) and/or interpersonal therapy? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

scholarly journals Chimney-Graft as a Bail-Out Procedure for Endovascular Treatment of an Inflammatory Juxtarenal Abdominal Aortic Aneurysm

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Francesca Fratesi ◽  
Ashok Handa ◽  
Raman Uberoi ◽  
Ediri Sideso
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Dense Adhesion ◽  
Technical Challenge ◽  
Abdominal Aortic ◽  
Vessel Patency ◽  
Chimney Graft ◽  
Bail Out

Inflammatory and juxtarenal Abdominal Aortic Aneurysm (j-iAAA) represents a technical challenge for open repair (OR) due to the peculiar anatomy, extensive perianeurysmal fibrosis, and dense adhesion to the surrounding tissues. A 68-year-old man with an 11 cm asymptomatic j-iAAA was successfully treated with elective EVAR and chimney-graft (ch-EVAR) without postprocedural complications. Target vessel patency and normal renal function are present at 24-month follow-up. The treatment of j-iAAA can be technically challenging. ch-EVAR is a feasible and safe bail-out method for elective j-iAAA with challenging anatomy.

Results of open pararenal abdominal aortic aneurysm repair: single centre series and pooled analysis of literature

Vascular ◽  
2016 ◽  
Vol 25 (3) ◽  
pp. 234-241 ◽  
Author(s):  
Guus W van Lammeren ◽  
Çağdaş Ünlü ◽  
Sjoerd Verschoor ◽  
Eric P van Dongen ◽  
Jan Wille ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Abdominal Aortic Aneurysm Repair ◽  
Pooled Analysis ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair ◽  
New Onset

Objectives Endovascular treatment of pararenal abdominal aortic aneurysm has gained terrain over the past decade, despite the substantial need for reinterventions during follow-up. However, open repair is still a well-established treatment option. With the current study we report the results of a consecutive series of elective primary open pararenal abdominal aortic aneurysm repair in a tertiary vascular referral centre, combined with an overview of current literature and pooled data analysis of perioperative mortality of open and endovascular pararenal abdominal aortic aneurysm repair. Methods A retrospective analysis of a prospective database of all elective open pararenal abdominal aortic aneurysm repairs in the St. Antonius Hospital between 2005 and 2014 was performed. Primary endpoint was 30-day mortality. Secondary endpoints were 30-day morbidity, new onset dialysis, reintervention free survival, and overall survival during follow-up. Results Between 2005 and 2014, 214 consecutive patients underwent elective open pararenal abdominal aortic aneurysm repair. Mean age was 69.8 (±7.1) years, 82.7% (177/214) were men, and mean abdominal aortic aneurysm diameter was 62 (±11) mm. Thirty-day mortality was 3.4%. Thirty-day morbidity was 27.1%, which predominantly consisted of pneumonia (18.7% (40/214)), cardiac events (3.3% (7/214)), and new onset dialysis (2.8% (6/214)). Estimated five-year overall survival rate was 74.2%. 0.9% (2/214) of patients required abdominal aortic aneurysm-related reintervention, and an additional 2.3% (5/214) required surgical repair of an incisional hernia. Pooled analysis of literature revealed a 30-day mortality of 3.0% for open pararenal repair and 1.9% for fenestrated endovascular repair. Conclusion Open pararenal abdominal aortic aneurysm repair in the era of increasing endovascular options results in acceptable perioperative morbidity and mortality rates. Mid-term reintervention rate is low compared to fenestrated endovascular aneurysm repair. Expertise with open repair still remains essential for treatment of pararenal abdominal aortic aneurysms in the near future, especially for those patients that are declined for endovascular treatment.

scholarly journals Abdominal aortic aneurysm repair: long-term follow-up of endovascular versus open repair

2014 ◽  
Vol 2 ◽  
pp. 273-282 ◽  
Author(s):  
Gabriele Piffaretti ◽  
Giovanni Mariscalco ◽  
Francesca Riva ◽  
Federico Fontana ◽  
Gianpaolo Carrafiello ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Abdominal Aortic Aneurysm Repair ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

scholarly journals Durability of open repair of infrarenal abdominal aortic aneurysm: A 15-year follow-up study

2002 ◽  
Vol 35 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Fausto Biancari ◽  
Kari Ylönen ◽  
Vesa Anttila ◽  
Jukka Juvonen ◽  
Pekka Romsi ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Infrarenal Abdominal Aortic Aneurysm ◽  
Follow Up Study ◽  
Abdominal Aortic

scholarly journals Endovascular Abdominal Aortic Aneurysm Repair – Patient Selection and Long-term Outcome Expectations – Current Challenges in 2013

2013 ◽  
Vol 8 (1) ◽  
pp. 57 ◽  
Author(s):  
Regula S von Allmen ◽  
Florian Dick ◽  
Thomas R Wyss ◽  
Roger M Greenhalgh ◽  
◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Open Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Abdominal Aortic ◽  
The Uk

Endografts for repair of abdominal aortic aneurysm were first reported in the late 1980s and commercially available grafts were developed rapidly during the 1990s. This prompted a head-to-head comparison of the new, less invasive, endovascular technology with the existing gold standard of open repair. The first and largest randomised trial of open versus endovascular repair for large aneurysms started in the UK in 1999. Other trials comparing open and endovascular repair followed in the Netherlands, France and the US. Only the UK trial has reported long-term follow-up to 10 years. This has shown no statistically significant difference in long-term survival after open or endovascular repair. Aneurysm-related mortality curves converged at six years, which is described as endovascular aortic repair (EVAR) ‘catch up’ on open repair. It appears that this convergence is probably largely attributable to secondary sac rupture after endovascular repair, which is fatal in about two-thirds of cases. At this point, we have reached a crossroads and only longer-term follow-up data can provide the vital answer to the outcome of endovascular repair in the long run. This article gives a brief overview of the development and the current evidence of endovascular aortic repair and discusses the most important factors that are leading the way to the future of this technology.

scholarly journals The Influence of Suprarenal Aortic Cross-clamping on Perioperative and Follow-up Results of Open Repair of Abdominal Aortic Aneurysm

2020 ◽  
Vol 72 (1) ◽  
pp. e54
Author(s):  
Walter Dorigo ◽  
Aaron Fargion ◽  
Sara Speziali ◽  
Alberto Melani ◽  
Fabrizio Masciello ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Abdominal Aortic

scholarly journals Five-year results of endovascular aortic repair used according to instructions for use give a good general outcome for abdominal aortic aneurysm

2019 ◽  
Vol 7 ◽  
pp. 205031211985343
Author(s):  
Runa G Unsgård ◽  
Martin Altreuther ◽  
Conrad Lange ◽  
Tommy Hammer ◽  
Erney Mattsson
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Abdominal Aortic ◽  
General Outcome ◽  
Secondary Procedures ◽  
Instructions For Use

Objectives: The primary aim of this study was to investigate the rate of sac enlargement and secondary procedures after 5 years when instructions for use are strictly applied with endovascular aortic repair. The secondary aim was to investigate if strict indications with endovascular aortic repair, rendering more open operations, would change the general outcome of patients with abdominal aortic aneurysm. Materials and methods: Patients having their abdominal aortic aneurysm procedure in a single institution between 01 January 2002 and 31 December 2006 were included. Indications for endovascular aortic repair were as follows: aortic neck: length 15 mm or more, diameter 32 mm or less and straight configuration; iliac arteries: length > 10 mm, 7.5–20 mm in diameter. Sac enlargement was defined as an increase in diameter of 5 mm or more. Results: A total of 123 patients were intended to be treated electively with endovascular aortic repair from 2002 to 2007 using Cook Zenith stent grafts. In the same period, 147 patients were treated with elective open repair. At 5 years, 7.3% (N = 9) of the elective intended-to-treat patients with endovascular aortic repair had a sac enlargement. Thirty-five percent of the patients were registered with endoleaks, 13% of the patients had secondary procedures, 12.2% of the patients had early and 6.5% late complications during the follow-up period. Aneurysm rupture was seen in 1.6% of the patients. During the 5-year follow-up period, 34 (27.6%) of the endovascular aortic repair patients died. Five-year mortality for open repair was 23.8%, and 12.2% of the open repair patients had secondary procedures. Conclusion: Endovascular aortic repair for abdominal aortic aneurysm in accordance with instructions for use gives a low long-term risk for increased diameter and low rate of secondary procedures. There was similar mortality after elective endovascular aortic repair and open repair for abdominal aortic aneurysm. Applying endovascular aortic repair according to instructions for use does not seem to change the general outcome of patients with abdominal aortic aneurysm but improves the outcome with the method.

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